By David Goldsmith, Satish Jayawardene, Penny Ackland
The ABC of Kidney disorder is a new name within the winning ABC sequence and is the reason this complex zone completely and obviously, in a pragmatic and simple demeanour. offering details on a wide selection of renal ailments, this publication guarantees non-renal healthcare staff may be able to monitor, determine, deal with and refer renal sufferers appropriately.Covering symptoms, signs, remedies and explanations of renal affliction, this name contains the typical matters proposing to GPs, what assessments to exploit, easy methods to interpret effects and while to refer a sufferer to a kidney professional. The ABC of Kidney sickness is a perfect useful reference for GPs, GP registrars and junior medical professionals.
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Additional info for ABC of Kidney Disease (ABC Series)
Asymptomatic bacteriuria does not generally need treatment except in pregnancy. • Pyelonephritis and renal abscesses are potentially life threatening. • Acute pyelonephritis is suggested by fever, chills, flank pain, fever, raised CRP and white cell count. • Kidney stones may vary from being asymptomatic, if tiny, to causing colicky loin (often radiating to groin) pain with visible haematuria. The pain may be so severe as to cause vomiting. The risk of infection and obstruction with such cases warrants urgent investigation.
Renal transplantation, if successful, can restore fertility and the chance of successful delivery; prednisolone azathioprine, mycophenolate, ciclosporin and tacrolimus are safe drugs to take in pregnancy (though breast feeding is often not recommended because of entry of these drugs into breast milk). Other newer immunosuppressants require more extensive research before we can be certain of their safety profiles. Further reading Bisceglia M, Galliani CA, Senger C, Stallone C, Sessa A. (2006) Renal cystic diseases: a review.
Anuria is an important clue, as this is otherwise unusual in ARF. Renal ultrasound is the method of choice to detect dilatation of the renal pelvis and calyces, although obstruction may be present without dilatation, particularly in cases of malignancy. Is the patient euvolaemic? Intravascular volume depletion is indicated by low venous pressure and a postural fall in blood pressure, whereas volume overload manifests as raised venous pressure and pulmonary crepitations. Circumstances leading to pre-renal ARF are almost invariably associated with high levels of plasma antidiuretic hormone, leading to increased tubular reabsorption of both water and urea and a disproportional increase in the plasma urea:creatinine ratio.
ABC of Kidney Disease (ABC Series) by David Goldsmith, Satish Jayawardene, Penny Ackland